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In the event an illness or injury requires more extensive treatment, I understand every reasonable attempt will be made to contact the family and/or emergency contacts listed in this form. However, in the event I cannot be reached, I consent for directors/staff of Prep Soccer Academy to authorize any necessary treatment. I understand that family medical insurance must be used. Prep Soccer Academy does not provide medical insurance for players.

Release of Liability: I/We, the undersigned, hereby certify that I (we) am (are) the parent or legal guardian of the player. I hereby give permission for the staff of the PREP SOCCER ACADEMY, L.L.C. to seek (during the period of the clinic) appropriate medical attention and for the player to receive medical attention and treatment, except for that covered by the clinic’s excess medical coverage policy. I/We, the undersigned, hereby acknowledge and understand that PREP SOCCER ACADEMY, L.L.C. are privately run sports clinics and are not operated by or through the Town of Brookline or City of Newton, but rather is under the sole sponsorship, control and supervision of the clinic administrator, PREP SOCCER ACADEMY, L.L.C.. I/We, the undersigned, for ourselves, our heirs, executors and administrator, waive, release and forever discharge the Town of Brookline and PREP SOCCER ACADEMY, L.L.C. staff, officers, agents, employees, representatives, successors and assign from any and all liability claims, demands, actions and causes of actions whatsoever arising out of or related to any loss, personal injury or property damage that may be sustained or occur during participation in clinic activities or while at the clinic. I certify that my child has never had to register under Article 7, Sex Offender Registry. I have read and understand the Release of Liability

I understand that this Prep Soccer Academy clinic and the high school tryout process ARE SEPARATE and IN NO MANNER RELATED. As a result, attending this clinic does not impact the tryout process in any way. All MIAA rules and regulations will be adhered to.